Provider Demographics
NPI:1588784490
Name:M J LEVITATS MD PA
Entity type:Organization
Organization Name:M J LEVITATS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MERON
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEVITATS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-785-0900
Mailing Address - Street 1:3170 N FEDERAL HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6700
Mailing Address - Country:US
Mailing Address - Phone:954-785-0900
Mailing Address - Fax:954-786-3497
Practice Address - Street 1:3170 N FEDERAL HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6700
Practice Address - Country:US
Practice Address - Phone:954-785-0900
Practice Address - Fax:954-786-3497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0487411400Medicaid
FL0487411400Medicaid
FLD84925Medicare UPIN